Cognitive therapy for premenstrual syndrome: a controlled trial.

Emphasizing research published in the past decade, this article presents a summary and evaluation of psychosocial investigations of women's reproductive health, with a focus on selected aspects of menstruation, pregnancy and birth, infertility, and menopause. In some areas, studies have focused on negative physical and psychological concomitants of these health issues. However, research reveals substantial individual variability, with most women adapting well to reproductive health changes. Although methodological and conceptual shortcomings have limited firm conclusions, research has advanced our understanding of the multivariate biological, psychological, and social influences on women's reproductive health and associated outcomes. Understanding and promoting women's reproductive health across the lifespan requires biopsychosocial approaches to research.

Psychosocial aspects of selected issues in women's reproductive health: current status and future directions.

This study examines the relative effectiveness of cognitive behavior therapy (CBT) (ten sessions), fluoxetine (20 mg daily) and combined therapy (CBT plus fluoxetine) in women with premenstrual dysphoric disorder (PMDD). This was a randomized pragmatic treatment trial with three treatment cells. Treatment lasted for 6 months; a naturalistic follow-up was undertaken 1 year post-treatment. One hundred and eight women, satisfying the DSM-IV criteria for PMDD with 2 months' prospective confirmation were recruited into the study; sixty of these had completed 6 months of treatment and all measures before and after treatment. The main outcome measures were premenstrual scores on the Calendar of Premenstrual Experiences (COPE) and percentage of PMDD cases (DSM-IV diagnostic criteria). Significant improvement occurred in all three treatment-groups after 6 months' treatment, assessed by the COPE. Fluoxetine was associated with a more rapid improvement. There were no group differences in the percentage of DSM cases of PMDD post treatment, but at follow-up CBT was associated with better maintenance of treatment effects compared with fluoxetine. In conclusion, CBT and fluoxetine are equally effective treatments for PMDD, but the treatments have some differential effects that can be considered in treatment decisions. There appears to be no additional benefit of combining the treatments.

A randomized comparison of psychological (cognitive behavior therapy), medical (fluoxetine) and combined treatment for women with premenstrual dysphoric disorder

Approximately 10% of women are severely affected by premenstrual syndrome (PMS) during their reproductive years. Several biological theories of causation have been proposed and each has provoked treatment attempts through medication to little sustained effect. As many of the reported complaints are psychological, a new treatment approach was considered using cognitive-behavioral therapy. A preliminary study which combined cognitive-behavioral therapy with drug treatment produced considerable symptom reduction. The present study examined the efficacy of cognitive-behavioral therapy alone in direct comparison with hormone treatment. Relaxation instructions were provided to a control group. Initial rapid responses to drug treatment and relaxation diminishes after 2 months, together with marked attrition in the control group. Significant positive benefits from cognitive-behavioral therapy were achieved after the first treatment month that continued throughout and were maintained at follow-up 3 months later. Implications for future management are discussed.

A comparison of hormone therapy, coping skills training, and relaxation for the relief of premenstrual syndrome

Background
Negative premenstrual change can result in distress for a significant proportion of women. Previous research has suggested that women employ a range of coping strategies and behaviours in order to manage and reduce premenstrual distress. However, as yet there has been no specific scale available to measure premenstrual coping. This research aimed to develop and validate a measure of premenstrual coping which can be used in future investigations of negative premenstrual experience.

/pdf/ways-of-coping-with-premenstrual-change-development-and-3ls07op5zb.pdf

Ways of coping with premenstrual change: development and validation of a premenstrual coping measure

Cognitive therapy for Premenstrual Syndrome

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Cognitive therapy for Premenstrual Syndrome